by J. R. McLeay
Over the course of the week, he’d seen steady increases in the number of Emergency Room admittances as well as average wait and treatment times. Starting slowly at the beginning of the week, the rate of increase had escalated dramatically, becoming a torrent by Friday morning. Most disturbing for the Chief of Staff, was the high proportion of NYDs and the capacity utilization figure for the hospital. As was the case the previous week when the ER was swamped in response to the tainted patch, hospital beds and staff were once again stretched to the limit. Joe had anticipated a temporary increase in hospital activity as a consequence of the patch error, but he’d expected the number and severity of cases to diminish as affected users quickly changed over to the correct juvenile doses. With a degree of foreboding and alarm, he’d called another meeting with his two endocrinology experts, Drs. Ross and Austin, to discuss the situation and try to establish appropriate containment measures.
At ten a.m., he heard a tap on his open door and looked up.
“Rick, Jennifer,” he acknowledged seeing the two doctors, “please come in. I’ve been reviewing the daily ops reports, and wanted to discuss the unsettling trend in admittances and NYDs that I’ve noticed accumulating through the week. We’re overstretching capacity once again, and I was hoping one or both of you might have some insights on what’s causing all this and what we should do about it.”
“Yes, I’ve noticed it too Joe,” Jennifer replied. “I’ve been spending more and more of my time this week treating walk-ins, and I don’t like what I see.”
“What have you been seeing? Aren’t the tainted patch users responding positively to the proper juvenile doses?”
“That seems to be the problem—most of them are not. Although many of their previous symptoms have abated, we’re seeing a raft of new, more troubling symptoms.”
“I can’t imagine anything worse than what we saw earlier in the week and over this past weekend. What are the primary diagnoses?”
“We’re still conducting tests to confirm a variety of causes, but the bulk of the cases appear to be complications of hypothyroidism and Addison’s Disease.”
“But those are diseases related to insufficient hormone production. I don’t understand—why would we be seeing that? Aren’t all the previously affected individuals now wearing good patches?”
“Yes, which is all the more troubling.”
“Have we tested the new patches to ensure they have the right hormone levels? Maybe we’ve got another instance of tampering?”
“I’ve been sending random samples down to our lab for evaluation throughout the week,” Jennifer stated, “and they assure me that all the patch hormones are within specified parameters. There have been no further anomalies.”
“What do you think is going on, then? Is it possible that the previously affected individuals haven’t yet returned to juvenile homeostasis, or that they need different dosages?”
“I’m afraid it’s looking more and more like that is precisely the case, Joe,” Rick weighed in. “I’ve consulted my contacts at the CDC and WHO, and they indicated they’re seeing exactly what we’re experiencing here at Mount Sinai—all across the country and around the globe.”
“Jesus,” Joe exclaimed, alarmed by the growing scale of the problem. “What do you recommend we do now? What are our options?”
Rick looked at Joe grimly.
“Unfortunately, I don’t think we should continue the present course of treatment using juvenile doses. The symptoms appear to be escalating in severity. It seems obvious now that the mature bodies of those previously exposed to the tainted patches have higher hormone requirements, and if they continue under these current deficit levels, we will see progressively deteriorating symptoms associated with hypothyroidism—starting with hypoglycemia, then anemia, eventually leading to diabetic ketoacidosis.”
“That’s fatal!”
“Exactly. We obviously have to examine an alternative course of action. I think we’re going to have to begin applying mature doses to try to reverse the decline and bring them back into stasis.”
“But that will mean…” Joe said, “they’ll all permanently become—adults?”
“Yes,” Rick replied, “hopefully healthy adults.”
Joe stared at Rick and Jennifer blankly for a few moments, as he contemplated the implications of this news.
“There’s no way we’ve got enough supplies of adult hormones on hand to treat everybody. Or the ability to restock our pharmacy through current sources.”
“I know,” Rick said. “We’ll have to begin ramping up production of new hormone patches in mature doses for those who’ve been affected. I’ve already put in a call to the Secretary-General to begin the provisioning process.”
“For everyone?” Joe asked, incredulously.
“Unfortunately, I don’t see any other way.”
“Do you think they’ll accept this—knowing what it means?”
Rick knew exactly what Joe meant. “I don’t think they have any other choice. It boils down to the choice between dying quickly, versus the expectation of a full and healthy mature lifespan.”
“Well, the shit is really going to hit the fan now,” Joe declared, slumping back in his chair. “I’d hate to be in the shoes of an Endogen executive when this comes out. The affected people will be breaking down their doors, looking for heads to roll.”
“It’s unfortunate, but they’re largely to blame for all this,” Rick mused. “Endogen should have had tighter controls on their production process. This latest development will only speed up the outsourcing of production to other suppliers.”
“Have the police made any progress on finding the primary culprit?” Jennifer enquired.
“From what I know, not yet,” Rick said. “But it’s only a matter of time. There are seven billion highly motivated people wanting to find the perpetrator—and very few people who had the motivation to commit the crime.”
“I assume they’re looking closely at that cult leader who caused such a disturbance here at the hospital last week,” Joe stated. “There’s not much doubt he has both the ability and motivation to do this sort of thing.”
“Maybe—we’ll just have to wait until the FBI has finished their investigation.”
“At least he’s in a place where he can’t cause any more trouble for a while,” Jennifer added, knowing Calvin had been remanded into custody.
“For now, yes. But I understand he’s being released temporarily to attend Elias’s service tomorrow.”
“What?” Jennifer exclaimed. “I can’t believe they’re letting him out!”
“He’ll be under close guard—they couldn’t very well not let him attend his own son’s funeral.”
“I hope you’ll be staying as far away from there as possible,” Jennifer said, immediately concerned for Rick’s safety.
“Actually, I intend to pay my respects. Especially since I feel partly responsible for what happened.”
“Surely you know there’s nothing more you could have done, Rick,” Joe interjected. “The autopsy confirmed the cause of death as a pulmonary embolism, which could not have been prevented. You did everything you could to save him. This unfortunate event was entirely his father’s doing.”
“I agree, Jennifer added. “I hope they charge him with murder and put him away for a very long time.”
“Something tells me this won’t be the last we’ll see of Dr. James,” Rick replied. “He’s shown himself to be a very determined and resourceful adversary.”
“Well, at least be careful tomorrow, Rick,” Joe said. “We certainly don’t want to generate any more friction between the two of you—who knows what else this character is capable of.”
“Don’t worry, I’ll be staying in the shadows. I have no intention of engaging Calvin any more than absolutely necessary. With luck, he won’t even see me.”
39
Saturday morning was brisk and chilly as Rick drove over the Brooklyn Bridge at the end of a long, slow-m
oving funeral procession. The sun was shining brightly, and on the bay below he could see the tiny billowing sails of sleek white sloops contrasted against the broad blue expanse of New York’s harbor. Passing under the soaring arch of the bridge’s west tower, Rick marveled at the beauty and engineering simplicity of the mile-long viaduct. Built more than two centuries ago to accommodate horse-drawn traffic, it was once the longest suspension bridge in the world and the tallest man-made structure in the western hemisphere. While many of its newer iron-and-concrete-clad neighbors sat crumbling and decaying, the Brooklyn Bridge’s prescient designer, John Roebling, choose to build his out of hardy granite and galvanized steel cables, which showed no sign of wear and tear, and easily bore the weight of thousands of tons of modern vehicles. Equally impressive was the simple and graceful beauty of the design. Approaching the twin gothic arches framing the massive tower on the Brooklyn side of the bridge, the interlocking latticework of cables looked to Rick like an elegant spider’s web of simplicity and strength. Taking the BQE expressway exit off the bridge, Rick nodded a silent tribute to another scientist who took his principal cues from nature.
Elias’s funeral was to take place in Green-Wood Cemetery, one of the oldest and grandest burial grounds in the United States, located next to Prospect Park in Brooklyn Heights. The spectacular grounds overlooking New York Bay comprised almost five hundred acres of rolling hills and dales, with a blanket of mature trees providing shelter for thousands of species of birds and other wildlife. When it opened in 1838, it was a popular respite for harried city dwellers, inspiring the subsequent development of other preeminent outdoor public spaces, including Manhattan’s Central Park. Along with its seasonal gaggle of Canadian geese and American black ducks, masked raccoons roamed the shadows at night with the many fireflies which lit up the sky like so many elusive spirits. Among its famous permanent denizens were such titans of industry, art, and politics as Leonard Bernstein, Louis Comfort Tiffany, Jean-Michael Basquiat, Samuel Morse, and Theodore and Alice Roosevelt.
As the long line of cars approached the main entrance gate at 5th Avenue and 25th Street, Rick slowed to behold the astonishing edifice. Modeled after Pere Lachaise, the famous eighteen-century Paris cemetery, the intricate facade looked like a cross between Paris’ Church of Notre Dame and the Temple of the Sagrada Familia in Barcelona, Spain. Carved out of solid red sandstone in the Gothic Revival style, its soaring triple spires and religious friezes evoked the grandeur and excess of medieval art and religious practice. The inscription above the main portico read “The dead shall be raised”, with the sculptural relief showing dramatic scenes of grieving and resurrection, reflecting the spiritual promise of rebirth. Near the top of the tower, a large copper bell sounded the arrival of the funeral procession, where a nesting flock of wild monk parakeets—descended from a single mating pair who escaped from a shipping container on route to South America via JFK airport—squawked their disapproval.
Only here, Rick thought, at this surreal interface between nature and architecture, could one find such an incongruous sight.
Continuing behind the wall into the quiet solitude of the park, Rick caught up with the funeral train as it moved to the right, passing a small byzantinesque chapel set in a quiet dale at the edge of a lily pond. Not much bigger than many of the stately mausoleums belonging to the wealthy families buried on the grounds, its central dome and four rounded turrets looked like a miniature version of Christ Church Cathedral in Oxford, England. Rarely used any longer for funeral services, it sat as a lonely sentinel over the tombs and crypts stretching far off into the distance.
As the procession slowly wound its way through the narrow serpentine paths leading into the necropolis, Rick was astonished at the beauty of the surrounding landscape. With trees and shrubs of every imaginable variety providing natural context for the graceful statuary and magnificent monuments, it reminded him of an immaculately groomed and palatial sculpture garden. Wild azaleas, dogwoods, and smoke brush sat juxtaposed with stately Victorian mausoleums in a harmonious interplay of nature and art. Most of the leaves had fallen from the deciduous trees at this late stage of the fall season, and the colorful dusting of discarded foliage created the impression of a rich ornamental carpet amongst the sculpted tombs. In springtime, Rick pictured it with the fallen petals from the hundreds of cherry trees on the estate, covering the ground like pink snow.
The slow-moving funeral procession afforded Rick a first-hand opportunity to take in the sights and sounds of the park. Many of the mausoleums and monuments were architectural masterpieces, and each had a story to tell. Resting between two giant blue cedars lay the tomb of the wealthy nineteenth century tobacconist John Anderson, accused of murdering his pregnant mistress. Designed in the Greek post-and-lintel style, its triangular pediment roof supported by four Ionic fluted columns called to mind the majestic Parthenon in ancient Athens. On the opposite side of the twisting lane at the end of a long granite stairway, lay the mausoleum of Imre Kiralfy, a Hungarian Jewish immigrant who produced many successful American Broadway shows at the turn of the century. Built in the classical Roman style, surrounded on all four sides by tall polished Corinthian columns, it sat majestically next to a large yellow elm tree. Further up the road next to a sleepy willow, stood the gaudy Egyptian pyramid-shaped tomb of the minor American composer Albert Ross Parsons, replete with reclining sphinx guarding its heavy copper doors. As if in silent protest, the simple bronze bust of Horace Greeley, founder of the New York Tribune, looked on disapprovingly atop a small granite pediment set amidst nearby craggy pine trees.
As the funeral procession continued its labyrinthine journey through the park, Rick gasped as he rounded a bend and glimpsed the imposing Neo-classical mausoleum of John MacKay, standing next to a majestic Japanese maple. The massive, tiered granite tomb, topped with a heavy Celtic cross, was larger than many New York City brownstones. No stranger to ostentatious displays of wealth during his day, MacKay, one of the richest Americans of the nineteenth century who discovered the largest silver deposit on the North American continent, had outfitted his tomb with electric heat and illumination.
But the largest tomb in Green-Wood cemetery belonged to Stephen Whitney, a prominent Manhattan Protestant and cotton speculator, who had his very own chapel built on the grounds. The magnificent eight-sided Gothic structure, surrounded by rhododendron, ivy, and ornamental trees, was equipped with a bench and table for contemplative visitors. Not far away, on the crest of a hill at the highest point in the park, stood The Civil War Soldiers’ Monument, a thirty-five-foot-tall soaring granite column guarded by four stoic soldiers, whose bronze effigies were fashioned from melted Confederate army cannons. The adjacent statue of Minerva, the Roman goddess of battle, standing with her outstretched arm saluting the Statue of Liberty across New York Bay, commemorated the Revolutionary War Battle of Long Island, fought on the site in August, 1776.
The procession finally slowed to a stop near a hillock overlooking the bay, where Rick saw the funeral party beginning to assemble under a large weeping beech tree, next to a small casket resting over an open hole in the ground. Stepping out of his car, he pulled up the collar of his heavy overcoat as much for protection against the biting wind as to conceal his identity, then found an inconspicuous spot under the tall tree’s pendulous branches, near the back of the assembly. The group was larger than he expected, and he was thankful that it allowed him to blend in amongst the crowd, especially since he noticed Calvin glance suspiciously in his direction as he approached the party. There was a conspicuously large complement of uniformed police standing a respectful distance back, to which Rick unconsciously edged closer. He recognized many people in the assembly as members of Calvin’s congregation, who he’d seen demonstrating many times outside the hospital and at U.N. headquarters. Scanning the crowd quickly, he recognized another familiar face: Nathan Taylor from his Bioethics class, who was standing next to a grim-faced Calvin James on the front row.
At the head of
the open grave stood a lone juvenile wearing long pastoral vestments, whom Rick did not recognize. It was strange to see someone other than Calvin preparing to give the benediction, but of course Rick knew Calvin’s freedoms would be tightly restricted under his present house arrest. The police were obviously not going to take any more unnecessary chances with this powerful and unpredictable individual temporarily unshackled.
When everybody was fully assembled, the pastor began his homily.
“Dearly beloved, we are gathered here today to lay to rest another Christian soul on these hallowed grounds…”
As the pastor paused to allow reflection, Rick could hear the wind whistling through the tall tombstones surrounding the gravesite.
“Though Elias’s life was taken from us prematurely,” the minister continued, “he now moves to a world of everlasting peace and blessed fulfillment—in God’s domain.”
Rick thought he caught a few hostile glances looking his way, and he pulled his collar up higher while inching closer to the relative safety of the police contingent.
“Let us pray now for our lost brother,” the pastor continued, “that his soul be delivered to the Lord—where he may be protected forever more in the Kingdom of Heaven.”
Many heads in the congregation bowed .
“Lord Jesus, who died for our sins, forgive the transgressions of our brother Elias, and grant that he may rise up so that he may bathe in your light and know the glory of God, for we know that only you hold the key to everlasting life.”
